Kerrison rongeurs have been used for many years during spinal and neurological procedures to safely remove tissue, such as bone and or cartilage, near delicate anatomical structures. The design has not changed much over the years, with the exception of surface coatings being applied to increase sharpness longevity. Recently, a “take-apart” kerrison rongeur has been utilized to make cleaning easier and more complete. Even with such a change a number of issues may remain for existing kerrison designs. The follow discussion indicates some example issues.
Reusable kerrison rongeurs are costly to buy and sharpen. Reusable kerrison rongeurs may only be sharpened a limited number of times. Non-ideal handling by surgeons can occur in connection with use of dull kerrison rongeurs. For example, surgeons might twist a dull kerrison and/or rock the dull kerrison up and down to help remove some tissue, such a bone. Such non-ideal handling might lead to bent or broken tips.
Reusable kerrison rongeurs can be difficult to clean properly. Patient blood and bone might be left in channels even after sterilization. It is possible that remaining/remnant blood and/or bone might thus be transferred to a next patient. Even though technically the remaining/remnant blood and/or bone may be sterile, sterilization may not kill prion type diseases like Creutzfeld-Jakob disease. Creutzfeld-Jakob disease may be incurable. Take-apart kerrison rongeurs can help address some of these issues. However, such an addressing aspect is associated with the hospital personnel and/or others involved in the sterilization process accomplishing a proper and complete disassembly.
Some reusable kerrison rongeurs have footplates that are thick to reduce bending or breaking. This leads to problems for surgeons, who may press the footplate toward/against the spinal cord or nerve root while removing bone leading to post-operative pain and spasms, or more serious issues. Surgeons want the thinnest footplates possible.
Current designs are not comfortable for surgeons to use, and carpel tunnel syndrome could be a problem for busy spine surgeons.
Small screws are used on the shaft and handle to hold them in place, and they can come loose and fall into the operative site.